Management of Children with HL Flashcards
What are the long-term goals of EI?
- Communicative competence
- Enhanced quality of life
Describe the audiologist’s role in the EI process.
- Being the discussion of communication progress with families
- Guide families who are struggling with full time HA use
- Connect consistent HA use to development of auditory and spoken language proficiency
- Parents may need to “buy into” therapeutic alliance
- Aided testing can help parents see the value of HAs
What is the “Amplification-Communication Connection.”
- 3-phase program
- AuDs can establish a foundation that fosters communication development in the early period following HL diagnosis
- Helps parents understand the role of technology as well as their role in communication development
- AuD may be the HL expert on the EI team
What are the 3 phases of the “Amplification-Communication Connection?”
1) Diagnosis through HAF
2) Early weeks following HAF, where the family becomes familiar with HAs (important to convey that it is common for families to experience difficulty with device use)
3) AuD should get a sense of adjustment to consistent, daily HA use
What are the ASHA principles of EI?
1) Services are family-centered and Culturally and Linguistically Responsive
2) Services are developmentally supportive and promote children’s participation in their natural environments
3) Services are comprehensive, coordinated, and team-based
4) Services are based on the highest quality evidence that is available
Describe ASHA principle of EI #1: Services are family-centered and Culturally and Linguistically Responsive.
- Coaching/parent-training model rather than “teacher-student” therapy model
- Respect for the family’s choice of communication methodology and goals
Describe barriers to ASHA principle of EI #1: Services are family-centered and Culturally and Linguistically Responsive.
- No clinician in the area trained in the chosen mode of communication
- No clinician or interpreter who speak family’s language
- Clinicians with necessary skills have full caseloads
- Trained EI clinicians may provide center-based treatment rather than home-based and aren’t authorized by Part C providers
- Communication bias (may be overt or subtle)
Describe barriers to ASHA principle of EI #2: Services are developmentally supportive and promote children’s participation in their natural environments.
- Shortage of EI providers with knowledge of HL (and working with infants)
- Natural environment policies
- Auditory condition in the child’s home
- Some families actually prefer center-based services
- No one solution fits all families
Describe barriers to ASHA principle of EI #3: Services are comprehensive, coordinated, and team-based.
-Many clinicians do not have training working with children who are D/HH with complex needs (requires multidisciplinary team of experts)
Describe barriers to ASHA principle of EI #4: Services are based on the highest quality evidence that is available.
- Shortage of qualified providers
- Families as source of barriers
Provide a summary of barriers to best EI services.
- Shortage of qualified interventionists with expertise in HL
- Regulations within Part C that create roadblocks and interpretations of certain regulations
- Failure to provide unbiased information
- Challenges originated in the child’s home or family
Describe characteristics and considerations of a pediatric prescriptive fitting method.
- DSL 5.0 method uses normative values based on age (and normal ME status)
- Implementation of auditory thresholds estimated from electrophysiological tests of hearing
- Accounting for external ear canal acoustics in assessment data
- Access to age-specific normative data for predicted ear canal acoustics
- Methods to conduct coupler assisted verification (i.e. RECD)
- Should be able to handle and compute targets based on partial audiometric data
- LDLs are predicted from auditory thresholds conservatively
Describe characteristics and considerations for pediatric hearing aids.
1) BTE style
2) Pediatric sized filtered earhook
3) Tamper resistant battery door
4) Deactivation or locking system for VC
5) Deactivation of advanced features
6) Direct audio input (DAI)
7) Choice of bright colors
What are the benefits of pediatric HA consideration #1: BTE style?
- Reduces acoustic feedback
- Provides greater electroacoustic flexibility
- Provides direct audio input capabilities
- Allows loaner device to be easily used if necessary
- Durable
What are the benefits of pediatric HA consideration #2: Pediatric sized filtered earhook?
- Supports secure retention on ear
- Reduces resonant peaks
- Allows for better match to targets
